Administrative Bulletin 12-18
114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals
June 7, 2012
Publication of Payment on Account Factors (PAFs) for Hospital Services
The Division of Health Care Finance and Policy, pursuant to 114.1 CMR 41.05(3), is issuing this bulletin to publish the Payment on Account Factors (PAFs) for acute and non-acute hospital services rendered to industrial accident patients effective July 1, 2012. The application of the PAF to all billed charges payable pursuant to 114.1 CMR 41.00 results in the payment of the average percentage of charges paid by the private sector to each hospital for its services and shall be deemed to meet the test of reasonable cost of medical services prescribed by M.G.L. c. 152, The Workers’ Compensation Act. No lesser amount shall be paid unless agreed to by the provider, insurer and employer. The PAFs for acute and non-acute hospitals for services rendered on or after July 1, 2012 are as follows:
Acute Hospitals 2012 PAF Anna Jaques Hospital 53.84% Athol Memorial Hospital 38.86% Baystate Franklin Medical Center 47.11% Baystate Mary Lane Hospital 49.87% Baystate Medical Center 57.55% Berkshire Medical Center 69.29% Beth Israel Deaconess Hospital - Needham 46.10% Beth Israel Deaconess Medical Center 53.36% Boston Medical Center 43.40% Brigham and Women's 42.56% Cambridge Health Alliance 41.09% Cape Cod Hospital 70.66% Clinton Hospital 24.89% Cooley Dickinson Hospital 63.37% Dana Farber Cancer Center 41.52% Acute Hospitals 2012 PAF Emerson Hospital 41.62% Fairview Hospital 73.21% Falmouth Hospital 72.23% Faulkner Hospital 42.08% Hallmark Health Systems 48.66% Harrington Memorial Hospital 56.85% HealthAlliance Hospitals, Inc. 39.90% Heywood Hospital 42.73% Holyoke Hospital 41.84% Jordan Hospital 48.08% Lahey Clinic Hospital 60.21% Lawrence General Hospital 42.38% Lowell General Hospital 54.47% Marlborough Hospital 32.17% Martha's Vineyard Hospital 57.50% Mass Eye & Ear Infirmary 39.42% Mass General Hospital 46.70% Mercy Hospital 42.37% Merrimack Valley Hospital 44.49% MetroWest Medical Center 45.95% Milford-Whittinsville Regional Hospital 44.80% Milton Hospital 40.81% Morton Hospital 55.50% Mount Auburn Hospital 54.39% Nantucket Cottage Hospital 65.94% Nashoba Valley Medical Center 33.42% New England Baptist Hospital 62.39% Newton-Wellesley Hospital 37.07% Noble Hospital 41.77% North Adams Regional Hospital 46.98% North Shore Medical Center 40.43% Northeast 54.33% Quincy Hospital 47.56% Saint Vincent Hospital 46.31% Saints Medical Center 40.29% Signature Healthcare Brockton Hospital 43.56% South Shore Hospital 63.99% Southcoast Health Systems 56.57% Steward Carney Hospital, Inc. 65.30% Steward Good Samaritan Medical Center 58.88% Steward Holy Family Hospital 49.32% Steward Norwood Hospital 55.68% Steward Saint Anne's Hospital 48.26% Steward St. Elizabeth's Medical Center 47.68% Sturdy Memorial Hospital 79.03% Tufts Medical Center 41.80% Acute Hospitals 2012 PAF UMMC 42.28% Winchester Hospital & Family Medical Center 60.12% Wing Memorial Hospital 44.15% Median PAF For new and out-of-state hospitals 47.04%
Non-Acute 2012 PAF Fairlawn 53.93% HealthSouth Braintree Rehab Hospital 47.20% HealthSouth New England Rehab Hospital 47.31% Kindred Park View Hospital 32.85% N.E. Sinai 37.82% Rehab Hospital of the Cape and Islands 60.99% Shaughnessy-Kaplan 57.83% Spaulding Rehab 48.51% Median PAF For new and out-of-state hospitals 47.31%